The title of this article is a “gallows-humor” type of joke that most Americans “get” instantly.  For our non-American members, it may help to point out that Abraham Lincoln, one of our most respected Presidents, was assassinated while attending a play with his wife.

The homeless Klingon I chose as a poster child for this article has got the idea of gallows humor just right, in these days of financial turmoil.  Not a Star Trek fan?  Forgedaboudit, you won’t get the joke.

I came across a thoughtful article on the subject of humor in oncology on the cancernetwork.com.  A small excerpt from it is below.  You can read the full article by clicking on the link.  Well worth the read, in my opinion.

Cancernetwork.com

Humor and Oncology

By L. Michael Glodé, MD.  August 11, 2011

Another vignette I can share is the patient whom you know well comes in after his or her scans demonstrate progression of disease after second- or third-line chemotherapy. You gently go over the options, focusing on palliative care as being your preference, and point out that additional therapy carries as much probability of doing harm as it does of doing good. The patient responds with words to the effect that “this is it, huh? There’s really nothing else you have to offer?” You go over phase I clinical trials, etc., but the telltale signs of cachexia, inanition, and so forth tell you that the patient really is within 3 to 6 months of dying. The pregnant question comes up: “So I’m really that close to the end?” To break the tension, I often introduce an image that has stayed with me since my teenage years. It comes from an old TV ad for life insurance.

A group of four guys are at a bowling alley, laughing, having a good time. From the left of the screen, two partially transparent gentlemen with wings emerging from the back of their business suits appear and walk up to one of the guys. They take him by each arm and lead him to a partially transparent escalator that has appeared on the far side of the lanes. As he is going up the escalator with the angels, he is heard to remark, “But wait, I was working on a spare!” I think this illustrates both the irony of being alive, our commonality in living as though we will never die, and an example of how humor can defuse one of the most challenging of situations we face.

Life sucks, most of the time. For some, it sucks more than usual.  Then we die.  How is that for a depressing view of life?  If that is all there is to it, why bother?  It makes what little life we do have not worth living.

I refuse to hold pity parties.  I will not be a Polyanna either. I fought this cancer tooth and nail for as long as I could, while my husband was alive.  Now that he is dead, I continue to fight it, with everything I got.  So, other than that your husband died, Mrs. Venkat, how are you enjoying the CLL scene?

CLL scene is just fine, cooking with gas, new drugs and new research improving chances for our patients.  If we keep our wits about us, if we actually get off of our well padded backsides and get personally involved in helping the patient community, some of these gleams of hope may even become reality.  Too late to be of help for my husband - but not too late for you and yours, and definitely not too late for your kids and grand-kids who may inherit this nasty disease. I do not know of anything that helps me regain my sanity after a bout of depression as much as my sense of humor.

A small minority (fortunately for my ego, a very small minority) of my readers find my sense of humor disrespectful.  I get a few emails asking me how I can possibly be so insensitive as to be snarky about this subject when people are dying, people are hurting, people are scared out of their wits.  Simple.  No one elected me god, and I cannot change life.  Which sucks, as we all know.  All I can do is teach you to better understand this disease.  I can think of no other way of making the medicine of patient education go down more smoothly than make it a bit funny.  You think you will understand T-cell function better if I made it all serious science, in the last article I wrote on the subject of  T-cell therapy?  Or is it easier to get the details if I tell the story in terms of clever criminals learning to avoid police officers struggling with paperwork or sleeping on the job?  By the way, I strongly urge you to read the T-cell therapy article.  The more I think about it, the more I like it.  Really cool stuff.

The following quote is from an anonymous cancer patient. I think he hit the nail right on its head.

“The other reactions—anger, depression, suppression, denial—took a little piece of me with them. Each made me feel just a little less human. Laughter made me more open to ideas, more inviting to others, and even a little stronger inside. It proved to me that, even as my body was devastated and my spirit challenged, I was still a vital human.

Believe me, I know all too well how hard it is to keep the old sense of humor alive and kicking.  The previous couple of weeks of silence and my reason for canceling the Fall workshop is mostly because I ran out of emotional steam. And my sense of humor drowned in a flood of tears.  Examining my own navel for too long has that unpleasant effect.  No more of that.  I will keep going for as long as I can, poking fun at cancer every chance I get.  And when I die, I hope I am able to flip the bird at cancer in general and CLL in particular, as the very last thing I do in this world.  It is my personal goal, and I hope it is yours too.

So, do us all a favor, tell us your best CLL joke.  We promise to laugh uproariously.